Individual
ERIC EUGENE MEDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
702 SW RAMSEY AVE STE 220, GRANTS PASS, OR 97527-5859
(541) 479-0765
(541) 479-3461
Mailing address
16083 SW UPPER BOONES FERRY RD STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
006236
CT
225100000X
Physical Therapist
Primary
3573
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2069033
—
OR
Enumeration date
11/30/2005
Last updated
03/17/2018
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